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Can two decades of research be wrong about the benefits of direct neurofeedback for neuropsychiatric disorders?

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I don’t think so!

With the growing awareness around complex trauma and the corresponding increase in mental health challenges, such as anxiety, depression, and addiction, it is mission critical that the healthcare system take off the blinders and drop the belief that prescription medications are the first line of attack to address such challenges. Most health care insurance will now cover acupuncture and chiropractic services, which are considered complimentary and alternative medicine (CAM) practices, in addition to more traditional, conventional medical services for what ails the body. However, they seem more reluctant to turn to CAM when addressing what ails the mind. After twenty years of research, direct neurofeedback or transcranial direct current stimulation has been shown to relieve the symptoms of many neuropsychiatric disorders.

The mind is the different levels of consciousness that arises from the brain, the main organ of our neurological or nervous system in the human body. Therefore, the mind works through the organ of the brain to think, feel and decide what action to take or not. So when we are challenged by our mental health, we can work with the mind and/or the brain. Traditionally, medications were prescribed for the brain while psychotherapy was prescribed for the mind. But what if someone is not responding to the medications or doesn’t want to take medications at all? How can we then work with the brain directly, while also working with the mind? That’s where direct neurofeedback comes in.

With the growing understanding of the neuroplasticity of the brain, more noninvasive brain stimulation options have been explored. Neuroplasticity is the nervous system’s innate ability to reorganize itself towards health and balance in response to stimuli by creating new neural networks in the brain. This facilitates the neurons to regulate their responses to new situations. Direct neurofeedback communicates with the brain directly in its own natural electromagnetic language, gently stimulating the brain’s neuroplasticity, facilitating the interruption of the imbalances of the brain and supporting the development of a more balanced state. This approach trusts in the human body’s inborn ability to heal itself when the support structures are organic.

When someone has a history of complex trauma, the body and mind naturally adapt for survival, and symptoms of that adaption include, but are not limited to, panic attacks, obsessive-compulsive thoughts and behaviors, fibromalgia, self-harm behaviors, impulsivity, chronic fatigue, poor concentration and procrastination. The American Psychiatric Association produces a book, called the Diagnostic and Statistical Manual of Mental Disorders, creating labels for all of these normal human adaptations to a chronic hostile environment. The book might be more appropriately titled Human Trauma Responses. When the healthcare system wears this lens when offering healing modalities, it can begin to embrace person-centered care that involves personal choice, which trauma robs us of. Within choice of healing journeys, CAM options become more available when backed by decades of research. As a safe and affordable neuromodulation approach, direct neurofeedback has potential in many clinical uses.

If you would like to read more about this research:

Two Decades of Research on Direct Neurofeedback Supporting Mental Health

Can neurofeedback be a “Nudge” to a Stuck Nervous System Due to Early Life Stress?

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Growing up in a single-mother household created a lot of stress and fear that stayed with me even as an adult.  Such a household dynamic brings a greater risk of poverty, which creates challenges in securing a safe place to live and putting food on the table on a consistent basis.  Fear in childhood from stressful experiences can change the trajectory of a person’s health over the entire life span if not addressed, specifically an elevated vulnerability to addiction in all of its forms.  Now, with the advent of the pandemic, we might need to add this to the long list of stressors that children struggle to adapt to as it might be years before the impact and lingering effects of the fear and isolation it has caused to be fully understood.  Is it possible that neurofeedback might be able to “nudge” the fearful nervous system back in the direction of health?

What we have learned about adverse childhood experiences and the traumatizing effects of such, is that talking about it may not be enough to move through the fear and calm the emotional centers of the brain.  More is needed and not everyone is willing to tolerate the side-effects of prescription medication, such as suicidal thoughts.  Therefore, research into alternative and complementary non-invasive, non-medication treatments, such as yoga and neurofeedback, has increased over the past couple of decades, with very promising results.

A recent review focused on neurofeedback to determine if it might help move the autonomic nervous system away from fear toward homeostatic equilibrium in people who experienced early life stress.  The researchers conclude that neurofeedback can increase the efficacy of other training protocols and more traditional talk therapy techniques.

Neurofeedback in Early Life Stress

Can primary care physicians jump start the complex PTSD healing journey of the underserved?

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As efforts to shine light on the underlying causes of health risk continue, especially as the disparities have become even clearer during this pandemic, the focus remains on the connection between adverse childhood experiences (ACEs) and the burden created on the human body individually and the healthcare system as a whole.  I am so grateful for Dr. Nadine Burke Harris, California’s Surgeon General who established early childhood, health equity and ACEs and toxic stress as key priorities, with a goal to reduce ACEs and toxic stress by half in one generation.

It still amazes me that so many people are not aware of the ACEs data that show the trauma our children endure, especially within low-income communities of color.  It has been out for years and continues to be collected every year, with expanding definitions of what constitutes adverse childhood experiences.  And it becomes frustrating when our healthcare systems continue to simply look at the symptoms of trauma, such as addiction, depression, and anxiety, without addressing the root cause.

I’m encouraged, and I hope you too find it encouraging, to learn that Dr. Burke Harris is starting with a campaign to provide Medi-Cal providers training, clinical protocols, and payment for screening children and adults for ACEs.  For more information on this campaign, you can click here.

It is also encouraging to hear about the research looking at other approaches to the chronic effects of trauma that are showing positive outcomes, especially within underserved primary care patient populations.  One particular pilot study tested the feasibility of a two-session motivational treatment intervention, implemented with Black primary care patients.  The intervention addressed adverse childhood experiences, post-traumatic stress symptoms, health risk behaviors and behavioral health referral acceptance.  The results were encouraging, suggesting that it is feasible to implement a brief motivational treatment with underserved primary care patients, that was received well and connected almost one-third of the participants to behavioral health services to continue the healing journey.

To read more on this pilot study, click the link below:

Mental Health intervention for Black primary care patients

Can direct neurofeedback help when our minds separate from our bodies?

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When we think about human senses, most of us are able to easily identify the five primary senses of sight, hearing, smell, taste and touch.  But did you know that we actually have three more senses that are integral to our fully embodied, lived experience as humans?  These are vestibular senses of body rotation, gravitation and movement, proprioception as the experience of agility, balance and coordination, and interoception as the ability to feel what is going on inside of our bodies.  It is this last one that is more recently coming forward into the light as it is critical in the healing process related to complex trauma.

When our sense of interoception is damaged, we might be challenged to know when we feel hungry or full, cold or hot, and/or thirsty.  It can also make self-regulation difficult.  When we learn it is not safe to attune to this sense or feel betrayed by it, the mind works to separate from the body, learning to ignore any sensations that emanate from the body, for fear those powerful sensations will reveal our inability to attend to them.  This manifested itself in my own experience when I grew up hungry due to food insecurity.  I quickly learned that the personal, physical sensation of discomfort that accompanies hunger was something I could ignore, especially when my next meal was consistently in question.  Then, when food was present, I had difficulty in portion control, often eating so much that I was in physical pain.

The sense of interoception is often adversely impacted when the human body experiences trauma, especially interpersonal trauma in childhood, and can be so badly damaged that it leads to fragmentation, such as dissociative conditions.  And our Western medical model supports this separation of body and mind, where medical students are trained to simply view the body as the focus for treatment and psychotherapists are trained to view the mind – and its thoughts – as the main focus of treatment.  As we start to embrace the inseparable mind-body connection and better understand the impact of complex mental traumatization, we are learning that talking about past traumas in therapy is only part of the healing process.  More is needed!

In fact, before venturing into cognitive trauma work, it is vital to create safety and some level of internal state regulatory capacity, so people recovering from complex post-traumatic stress disorder (C-PTSD) can avoid the overwhelm that leads to dissociation and holds them back from post-traumatic growth.  Research is now showing that neurofeedback therapy (NFT), like direct neurofeedback, can be added to the treatment of C-PTSD as a method of implicit regulation, changing the brain in a way that eases the symptoms of trauma and opening the window wide to deep healing and inner peace.

If you would like to read more, click on the link below:

What neuroscience and neurofeedback can teach psychotherapists in the field of complex trauma